Opioid abuse and addiction affect millions of people in the United States. An estimated 2.5 million people suffer from opioid use disorder and more than 80,000 overdose deaths involve opioids each year.[1]
Many people develop an addiction to controlled substances after taking prescription opioids to manage moderate to severe pain–an estimated 3-19%.[2] Others quickly develop physical dependence on opioids after experimenting with illicit drugs.
All opioids have the risk of misuse and addiction. Some opioids are more potent than others. Understanding the risk of opioid abuse and addiction can help you seek treatment and work toward long-term recovery.
This article will provide a list of the strongest and weakest opioids. You will also learn:
- How opioid addiction develops
- How to recognize opioid addiction
- Where to find opioid use disorder treatment
If you or a loved one are one of the millions of people in the United States struggling with opioid addiction, you are not alone. Holistic, effective treatment is available at Alamo Behavioral Health. Contact our intake specialists to learn about our programs or to schedule an intake assessment.
A List of Opioids From Strongest to Weakest
Opioids work by binding to brain receptors in areas related to reward, pleasure, and pain control. They can cause pleasurable side effects, including relaxation and euphoria.[3]These pleasurable effects may make people want to take them differently than prescribed.
All opioids have the potential to be addictive. Here is a list of opioids from strongest to weakest.
1. Fentanyl
Fentanyl abuse has risen sharply in the United States in recent years. Fentanyl is one of the strongest pain medications available in a medical setting. It is typically used when anesthetizing patients and helping treat post-surgical pain.
People may also take fentanyl to manage severe pain. It is 50 times stronger than heroin and 100 times stronger than morphine.[4] People who abuse this highly addictive drug are at significant risk of an opioid overdose.
2. Oxymorphone
Oxymorphone is a semi-synthetic drug doctors prescribe to treat severe pain. It is a highly addictive prescription drug. The Food and Drug Administration (FDA) asked the manufacturer of oxymorphone to remove it from the market over concerns about misuse and addiction.
3. Hydromorphone
Hydromorphone is derived from morphine. Patients in a medical setting may receive hydromorphone to relieve severe pain after surgery or medical procedures. It is among the strongest opioids available on the market and is highly addictive.
4. Heroin
Heroin is an illicit Schedule I drug. People may use heroin recreationally. The risk of overdose from heroin is high, with thousands of people losing their lives to an overdose each year.
Many people with prescription opioid addiction turn to heroin when they can no longer obtain their prescription drugs. Heroin is about 2-4 times stronger than morphine.[5]
5. Levorphanol
Levorphanol is a synthetic, prescription pain management drug. People take it to manage moderate to severe pain. This addictive drug is more potent than morphine.
6. Methadone
Methadone is a prescription drug used in the treatment of opioid dependence. People may also use it to manage neuropathic pain. When compared with other opioids, methadone has a lower risk of misuse and dependence.
7. Oxycodone
Oxycodone is synthesized from a compound found in the opium poppy. It is about 1.5 times stronger than morphine but is more effective at managing pain.[6] People may develop physical dependence after just a short period of misusing oxycodone.
8. Tapentadol
Some medical professionals classify tapentadol as stronger than morphine because it is more effective at relieving pain than the same dose of oxycodone. However, it has a “dose ceiling,” meaning that the effects of the drug level off after a specific dose.
9. Morphine
Morphine is derived from a compound found in the opium poppy plant. Medical professionals may prescribe morphine for patients with mild to moderate pain or severe pain. More than ⅔ of all morphine people produce goes toward the production of other drugs, including heroin and oxymorphone.[7]
10. Hydrocodone
Hydrocodone is a semi-synthetic opiate. The compounds used to create hydrocodone are found within the opium poppy plant. Hydrocodone is often prescribed to treat moderate to severe pain. People in the United States use 99% of the world’s hydrocodone.[8]
Doctors may prescribe opioids like hydrocodone in combination with other pain relievers, including:
- Hydrocodone and acetaminophen (Vicodin)
- Hydrocodone and aspirin (Lortab)
- Hydrocodone and ibuprofen (Vicoprofen)
These drug combinations may be available in liquid and tablet form.
Doctors typically prescribe opioids for short periods to limit the risk of misuse and addiction. However, people may become addicted to opioids after using them as prescribed or misusing them for brief periods.
Additional weaker opioids include codeine and tramadol.
Recognizing and Treating Opioid Addiction
People may become addicted to opioids after misusing them. Some common signs of opioid abuse and addiction include:
- Taking higher or more frequent doses of opioids than prescribed
- Needing to take higher doses to get the desired effects
- Doing illegal things to get more opioids
- Isolating
- Neglecting hygiene, hobbies, relationships, or responsibilities
- Experiencing withdrawal symptoms when not taking opioids
People who become addicted to opioids will continue to take them despite serious or life-threatening harm. Opioid dependence is a severe, complex condition that requires comprehensive treatment.
Get Help Now
If you or someone you love struggles with opioid abuse or addiction, contact the Alamo Behavioral Health specialists to explore our holistic treatment programs.
References:
- National Institute on Drug Abuse (NIDA): Only 1 in 5 U.S. adults with opioid use disorder received medications to treat it in 2021
- American Psychiatric Association (APA): Opioid Use Disorder
- Johns Hopkins Medicine: Opioids
- United States Drug Enforcement Administration (DEA): Fentanyl
- NIDA: Heroin
- National Institutes of Health (NIH): Different effects of morphine and oxycodone in experimentally evoked hyperalgesia: a human translational study
- DEA: Morphine
- MN Department of Health: Perception of Pain
